Individual
JILLIAN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2995 N COLE RD, BOISE, ID 83704-5964
(208) 570-0461
Mailing address
2995 N COLE RD, BOISE, ID 83704-5964
(208) 570-0461
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
43030
ID
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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